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D-dimer values increase during pregnancy, and although a D-dimer test has high specificity in women suspected of having deep vein thrombosis who are not pregnant, it is thought to have limited value in pregnant women. Previous studies confirmed that rapid enzyme linked immunosorbent assay D-dimer tests and latex agglutination tests yielded too many false positive results to be of clear diagnostic value in pregnant women.
A recent study that looked at the diagnostic accuracy of the SimpliRED assay seems to give more encouraging results. Among 149 pregnant women suspected of having deep vein thrombosis, a detailed diagnostic procedure that included compression ultrasonography and three months of clinical follow-up confirmed the diagnosis in 13 (8.7%) of the women.
The SimpliRED assay was positive in all these women, and also had an acceptable specificity of 60%. Still, because of the low number of cases and wide confidence intervals, these results need to be intrepreted cautiously. Doctors will particularly need to take into account clinical presentation, which is made difficult by the lack of a validated, structured clinical prediction rule for pregnant women.